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Encyclopaedia


Flu, seasonal

Introduction

Flu, seasonal

Flu is a common infectious viral illness spread by coughs and sneezes. It can be very unpleasant, but you'll usually begin to feel better within about a week.

You can catch flu – short for influenza – all year round, but it's especially common in winter, which is why it's also known as "seasonal flu".

It's not the same as the common cold. Flu is caused by a different group of viruses and the symptoms tend to start more suddenly, be more severe and last longer.

Some of the main symptoms of flu include:

  • a high temperature (fever) of 38C (100.4F) or above
  • tiredness and weakness
  • headache
  • general aches and pains
  • a dry, chesty cough

Cold-like symptoms – such as a blocked or runny nose, sneezing, and a sore throat – can also be caused by flu, but they tend to be less severe than the other symptoms you have.

Flu can make you feel so exhausted and unwell that you have to stay in bed and rest until you feel better.

Read more about the symptoms of flu.

What to do

If you're otherwise fit and healthy, there's usually no need to see a doctor if you have flu-like symptoms.

The best remedy is to rest at home, keep warm and drink plenty of water to avoid dehydration. You can take paracetamol or ibuprofen to lower a high temperature and relieve aches if necessary.

Stay off work or school until you're feeling better. For most people, this will take about a week.

Read more about treating flu at home.

When to see your GP

Consider visiting your GP if:

  • you're 65 years of age or over
  • you're pregnant
  • you have a long-term medical condition – such as diabetes, heart disease, lung disease, kidney disease or a neurological disease
  • you have a weakened immune system – for example, because you're having chemotherapy or have HIV
  • you develop chest pain, shortness of breath or difficulty breathing, or start coughing up blood
  • your symptoms are getting worse over time or haven't improved after a week

In these situations, you may need medication to treat or prevent complications of flu. Your doctor may recommend taking antiviral medicine to reduce your symptoms and help you recover more quickly.

Read more about antiviral medication for flu.

How long does flu last and is it serious?

If you have flu, you generally start to feel ill within a few days of being infected.

You should begin to feel much better within a week or so, although you may feel tired for much longer.

You will usually be most infectious from the day your symptoms start and for a further three to seven days. Children and people with weaker immune systems may remain infectious for longer.

Most people will make a full recovery and won't experience any further problems, but elderly people and people with certain long-term medical conditions are more likely to have a bad case of flu or develop a serious complication, such as a chest infection.

Read more about the complications of flu.

How you catch flu

The flu virus is contained in the millions of tiny droplets that come out of the nose and mouth when someone who is infected coughs or sneezes.

These droplets typically spread about one metre. They hang suspended in the air for a while before landing on surfaces, where the virus can survive for up to 24 hours.

Anyone who breathes in the droplets can catch flu. You can also catch the virus by touching the surfaces that the droplets have landed on if you pick up the virus on your hands and then touch your nose or mouth.

Everyday items at home and in public places can easily become contaminated with the flu virus, including food, door handles, remote controls, handrails, telephone handsets and computer keyboards. Therefore, it's important to wash your hands frequently.

You can catch flu many times, because flu viruses change regularly and your body won't have natural resistance to the new versions.

Preventing the spread of flu

You can help stop yourself catching flu or spreading it to others with good hygiene measures.

Always wash your hands regularly with soap and warm water, as well as:

  • regularly cleaning surfaces such as your computer keyboard, telephone and door handles to get rid of germs
  • using tissues to cover your mouth and nose when you cough or sneeze
  • putting used tissues in a bin as soon as possible

You can also help stop the spread of flu by avoiding unnecessary contact with other people while you're infectious. You should stay off work or school until you're feeling better.

In some people at risk of more serious flu, an annual flu vaccine (see below) or antiviral medication may be recommended to help reduce the risk of becoming infected.

Read more about how to stop the spread of flu.

The flu vaccine

A flu vaccine is available free on the NHS for:

  • pregnant women
  • children aged two, three and four and children in school year 7
  • children aged 6 months – 17 years who have a health condition that increases their risk of being very ill with flu
  • adults aged 65 or older
  • adults with a health condition that increases their risk of developing complications from flu
  • carers
  • people living in a residential or nursing home
  • members of voluntary organisations providing planned emergency first aid
  • Community First Responders (active members of a Welsh Ambulance Service Trust scheme who provide first aid directly to the public)
  • Health and social care workers who have direct patient/client contact (vaccine available through occupational health service)

The best time to have the vaccine is in the autumn, between September and early November. If you think you might need it, contact your local GP surgery.

You should have the flu vaccination every year so you stay protected, as the viruses that cause flu change every year.

For more information on who should have the flu jab and how to get it see Seasonal flu jab.

Flu vaccine for children 

This autumn (2014), the nasal spray flu vaccine will be offered to all children aged two, three and four years and children in school year 7 as part of the NHS childhood vaccination programme.

Children who were aged 2, 3 and 4 years of age on the 31st of August 2014 will be vaccinated through primary care (GP practices) using a nasal spray, and children in school year 7 through the school nursing service.

Children aged six months to less than 2 years with a health condition that increases their risk of being very ill from flu will be given their flu vaccine by injection.

The flu vaccine programme will be extended over a number of years to eventually include all children aged two to 16 inclusive.

Read more about children and teens having the seasonal flu vaccine.

Other types of flu

As well as seasonal flu, there are several other types of flu. These include:

  • bird (avian) flu – a type of flu spread among birds that affects humans in rare cases
  • swine flu – the type of flu that was responsible for the flu pandemic in 2009-10
  • "gastric flu" (gastroenteritis) – an infection of the digestive system, which can be caused by bacteria or viruses such as the norovirus

Click on the links above for more information about these types of flu.

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Symptoms

The symptoms of flu usually develop within one to three days of becoming infected. Most people will feel better within a week.

However  you may have a lingering cough and still feel very tired for a further couple of weeks.

Main symptoms

Flu can give you any of the following symptoms:

Is it flu or a cold?

It can sometimes be difficult to tell if you have flu or just a common cold as the symptoms can be quite similar. The main differences are:

Flu symptoms:

  • come on quickly
  • usually include fever and aching muscles
  • make you feel too unwell to continue your usual activities

Cold symptoms:

  • come on gradually
  • mainly affect your nose and throat
  • are fairly mild, so you can still get around and are usually well enough to go to work

When to visit your GP

If you are otherwise fit and healthy, there is usually no need to visit your GP if you have flu-like symptoms.

You should just rest at home until you feel better, while keeping warm, drinking plenty of water and taking painkillers if necessary. Read more about how to treat flu.

You should visit your GP if you have flu-like symptoms and you:

  • are 65 years of age or over
  • are pregnant
  • have a long-term medical condition, such as diabetes, heart disease, lung disease, kidney or neurological disease
  • have a weakened immune system – for example, because you're having chemotherapy or have HIV
  • you develop chest pain, shortness of breath or difficulty breathing, or start coughing up blood
  • your symptoms are getting worse over time or haven't improved after a week

In these situations, you may need extra treatment to prevent or treat complications of flu.

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Diagnosis

If you are otherwise fit and healthy, you don't need to see your GP when you have flu.

Read more about treating flu

When you should see your GP

You should see your GP if you have flu and any of the following applies to you:

  • Your symptoms have got much worse and include shortness of breath, chest pain or coughing up blood, or you have developed other symptoms that are not typical of flu, such as a rash.
  • Your symptoms have lasted for longer than a week.
  • You have a medical condition that is making your flu worse (see complications of seasonal flu).

Your GP will diagnose flu based on your symptoms and your medical history. If they suspect that your symptoms are caused by a different condition for example, malaria, if you have recently been travelling, you may need to have further tests or a referral to a hospital specialist.

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Treatment

If you have flu, it will usually be possible to treat yourself effectively at home.

In which case you should:

  • rest
  • keep warm
  • drink plenty of water to avoid dehydration
  • try to take paracetamol or anti-inflammatory medicines such as ibuprofen if you feel unwell to lower a high temperature and relieve aches

If you are in a 'high-risk' group (see below) and are more likely to suffer complications from flu, your doctor may prescribe antiviral medication.

Antivirals will not cure flu but will help to:

  • reduce the length of time you are ill by around one day
  • relieve some of the symptoms
  • reduce the potential for serious complications.

Antibiotics are not prescribed for flu as they have no effect on viruses. However, occasionally it may be necessary to treat complications of flu, especially serious chest infections or pneumonia, with a course of antibiotics.

Antiviral medications

The use of antivirals in Wales is now recommended in line with NICE guidance for Influenza season 2013/14:

People in groups most at risk of complications may require medical attention earlier. GPs may prescribe antiviral medications such as Oseltamivir and Zanamivir  to exposed, unprotected individuals at risk of complications from flu (when flu is circulating).  This is for both the treatment and prevention of flu, following the guidelines produced by the National Institute for Health and Clinical Excellence (NICE).

GPs can also prescribe antiviral medicines as a treatment or prevention measure to those not in identified at-risk groups if there is a risk of developing complications.   

Who needs antivirals?

High-risk groups

You may be prescribed antivirals if you are

  • pregnant
  • 65 or over

Or if you have:

  • lung disease
  • heart disease
  • kidney disease
  • liver disease
  • neurological disease (such as motor neurone disease, Parkinson's disease or multiple sclerosis)
  • a weakened immune system 
  • diabetes

Antivirals work by stopping the virus from multiplying in your body. There are two main types:

  • Tamiflu
  • Relenza

Tamiflu (Oseltamivir)

Tamiflu is taken by mouth (orally) in capsule or liquid form. You need to start taking Tamiflu within 48 hours of getting the first symptoms of flu.

The dose is usually one tablet twice a day for five days. However, if you have kidney disease you may be prescribed a lower dose.

Tamiflu can cause nausea, vomiting, stomach pain and diarrhoea. These side effects should not be serious but see your GP if you are worried.

Relenza (zanamivir)

Relenza is a dry powder that you breathe in through an inhaler. As with Tamiflu, you need to start taking it within 48 hours of your first flu symptoms (36 hours for children). The dose is two inhalations twice a day for five days.

It's a safe treatment that rarely has any side effects.

Antiviral medication can sometimes be taken to prevent flu.

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Complications

Complications of flu mostly affect people in high-risk groups such as the elderly, pregnant women and those who have a long-term medical condition or weakened immune system.

The most common complication is a bacterial chest infection. Occasionally, this can become serious and develop into pneumonia.

A course of antibiotics usually cures a chest infection or pneumonia, but it can very occasionally become life threatening, particularly in the frail and elderly.

Other serious complications are uncommon.

Rare complications

Rare complications include:

  • tonsillitis
  • otitis media (a build-up of fluid in the ear),
  • septic shock (infection of the blood that causes a severe drop in blood pressure)
  • meningitis (infection in the brain and spinal cord)
  • encephalitis (inflammation of the brain).
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Prevention

There are three main ways of preventing flu.

  • Good hygiene – such as handwashing and cleaning
  • Flu vaccination
  • Antiviral medicines

Good hygiene

Preventing the spread of germs is the most effective way to slow the spread of flu. Always:

  • make sure you wash your hands regularly with soap and water,
  • clean surfaces like your keyboard, telephone and door handles regularly to get rid of germs,
  • use tissues to cover your mouth and nose when you cough or sneeze, and
  • put used tissues in a bin as soon as possible.

The flu vaccine

A flu vaccine is available free on the NHS for:

  • pregnant women
  • children aged two, three and four and children in school year 7
  • children aged 6 months – 17 years who have a health condition that increases their risk of being very ill with flu
  • adults aged 65 or older
  • adults with a health condition that increases their risk of developing complications from flu
  • carers
  • people living in a residential or nursing home
  • members of voluntary organisations providing planned emergency first aid
  • Community First Responders (active members of a Welsh Ambulance Service Trust scheme who provide first aid directly to the public)
  • Health and social care workers who have direct patient/client contact (vaccine available through occupational health service)

Despite popular belief, the flu vaccine cannot give you flu as it doesn't contain the active virus needed to do this.

The flu vaccine is available from October each year. If you think you need it, talk to your GP or practice nurse.

For more information on who should have the flu jab and how to get it see Seasonal flu jab.

Flu vaccine for children 

This autumn (2014), the nasal spray flu vaccine will be offered to all children aged two, three and four years and children in school year 7 as part of the NHS childhood vaccination programme.

Children who were aged 2, 3 and 4 years of age on the 31st of August 2014 will be vaccinated through primary care (GP practices) using a nasal spray, and children in school year 7 through the school nursing service.

Children aged six months to less than 2 years with a health condition that increases their risk of being very ill from flu will be given their flu vaccine by injection.

The flu vaccine programme will be extended over a number of years to eventually include all children aged two to 16 inclusive.

Read more information about the seasonal flu vaccine.

Vaccination advice for pregnant women

The flu vaccine will be offered to ALL pregnant women at any stage of pregnancy.

Read more about the seasonal flu jab during pregnancy, including background information on the vaccine and how you can get the jab.

Antiviral medication

The National Institute for Health and Clinical Excellence (NICE) recommends the antiviral medicines Relenza or Tamiflu to prevent flu if all of the following apply:

  • There is a lot of flu around.
  • You have a medical condition that puts you at risk of flu such as diabetes, heart disease, lung disease or kidney disease. 
  • You are aged 65 or over.
  • You have been in contact with someone with a flu-like illness and can start antiviral treatment within 48 hours
  • You have not been effectively protected by vaccination

You are not effectively protected by vaccination if you:

  • have not been vaccinated since last winter
  • cannot be vaccinated, or have been vaccinated but it has not taken effect yet
  • have been vaccinated for a different form of flu virus

If there is an outbreak of flu in a residential or nursing home – where the flu virus can often spread very quickly – antiviral medication may be offered to people if they have been in contact with someone with confirmed flu.

For more information, go to the NICE guidelines on antivirals to prevent influenza.

Do I need the flu jab every year?

Yes. If you’re in a high-risk group, you should have the seasonal flu vaccination every year, so that you stay protected.

The viruses that cause flu change every year, so this winter’s flu will be different from last winter's. The 2013/14 flu vaccine will therefore be different as well.

Find out if you should have the annual flu jab.

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Leaflets

Welsh Government Leaflets

 

Flu Leaflet pdf

Poster for schools pdf

"Flu Vaccination for Children" leaflet pdf

"Seasonal Flu" Easy Read Leaflet pdf

"Think You Know Flu?" poster pdf

"Protecting Health and Social Care Workers from Flu" leaflet pdf

"Protect Yourself and Others 1" poster for healthcare professionals pdf

"Protect Yourself and Others 2" poster for healthcare professionals pdf

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 10/06/2015 08:32:06

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